The use of the medial head of the gastrocnemius muscle in the posterior cruciate-deficient knee. Indications--technique--results.

This review retrospectively analyzes a group of patients with chronic posterior cruciate insufficiency who were treated surgically with transfer of the medial head of the gastrocnemius muscle. Our indications, technique, and the results of this surgery are presented. Twenty-one patients (21 knees) over the last 31/2 years, from January 1977 to June 1980, were treated by this procedure. Eighteen patients were followed up for more than 8 months after surgery and are included in the review. Subjectively, pain, swelling, reduction activity, and functional instability were assessed and graded from 0+ to 3+. Postoperative examination showed improvement of these parameters in most patients. Objectively, assessment of effusion, patellofemoral joint symptoms, stability, and recurvatum were tabulated and compared to preoperative information. Of greatest significance was improvement of the patient's overall functional classification in most cases. The posterior sag or drawer sign and patellofemoral complaints were not altered by the operation. Gait analysis and isokinetic testing were performed as part of the followup on 50% of the patients. We advocate this as a safe, effective reconstructive procedure for the posterior cruciate deficient knee with significant advantages over alternative techniques.